- 1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
- 2. Department of Thoracic Surgery, Shangjin Hospital West China Hospital/Chengdu Shangjin Nanfu Hospital, Chengdu, 611743, P. R. China;
ZHU Yunke,
Email: yunke_zhu@qq.com;
SHEN Cheng,
Email: shencheng568_hx@163.com
As an important method for minimally invasive treatment of pulmonary nodules, cryoablation and thermal ablation have the advantages of short hospital stay and low medical cost, with a higher cost-effectiveness ratio. Cryoablation, with its "visual ice ball effect" and lower "heat sink effect", shows unique advantages in the treatment of nodules near large blood vessels, airways and other special areas. Among thermal ablation techniques, microwave ablation, with its high heating efficiency and less influence from blood flow, has become the preferred option for nodules larger than 3 cm or those adjacent to blood vessels; radiofrequency ablation has a higher local control rate in small-volume (less than 1 cm) nodules and subsolid nodules. Through literature review, it is found that there are few studies comparing cryoablation and thermal ablation and systematically and comprehensively elaborating on the application status, safety and management of complications of cryoablation and thermal ablation. Therefore, this article will systematically review the basic principles of cryoablation and thermal ablation, the current clinical application status in pulmonary nodules, the comparison between cryoablation and thermal ablation, and the safety and management of complications.
Copyright ? the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
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- 1. de Baère T, Woodrum D, Tselikas L, et al. The ECLIPSE study: efficacy of cryoablation on metastatic lung tumors with a 5-year follow-up. J Thorac Oncol, 2021, 16(11): 1840-1849.
- 2. Dupuy D, Zagoria R, Akerley W, et al. Percutaneous radiofrequency ablation of malignancies in the lung. AJR Am J Roentgenol, 2000, 174(1): 57-59.
- 3. Lassandro G, Picchi S, Corvino A, et al. Ablation of pulmonary neoplasms: review of literature and future perspectives. Pol J Radiol, 2023, 88: e216-e224.
- 4. Strand N, Hagedorn J, Dunn T, et al. Advances in radiofrequency ablation: mechanism of action and technology. Ann Palliat Med, 2024, 13(4): 1028-1034.
- 5. Ridge C, Solomon S, Thornton R. Thermal ablation of stageⅠnon-small cell lung carcinoma. Semin Intervent Radiol, 2014, 31(2): 118-124.
- 6. Vogl T, Naguib N, Lehnert T, et al. Radiofrequency, microwave and laser ablation of pulmonary neoplasms: clinical studies and technical considerations-review article. Eur J Radiol, 2009, 77(2): 346-357.
- 7. Lubner M, Brace C, Hinshaw J, et al. Microwave tumor ablation: mechanism of action, clinical results, and devices. J Vasc Interv Radiol, 2010, 21(8 Suppl): S192-S203.
- 8. Gala K, Shetty N, Patel P, et al. Microwave ablation: how we do it. Indian J Radiol Imaging, 2020, 30(2): 206-213.
- 9. Rosenberg C, Puls R, Hegenscheid K, et al. Laser ablation of metastatic lesions of the lung: long-term outcome. AJR Am J Roentgenol, 2009, 192(3): 785-792.
- 10. Haen S, Pereira P, Salih H, et al. More than just tumor destruction: immunomodulation by thermal ablation of cancer. Clin Dev Immunol, 2011, 2011: 160250.
- 11. Baust J, Snyder K, Santucci K, et al. Cryoablation: physical and molecular basis with putative immunological consequences. Int J Hyperthermia, 2019, 36(sup1): 10-16.
- 12. Chen Z, Meng L, Zhang J, et al. Progress in the cryoablation and cryoimmunotherapy for tumor. Front Immunol, 2023, 14: 1094009.
- 13. Chu K, Dupuy D. Thermal ablation of tumours: biological mechanisms and advances in therapy. Nat Rev Cancer, 2014, 14(3): 199-208.
- 14. Yang W, Wang W, Liu B, et al. Immunomodulation characteristics by thermal ablation therapy in cancer patients. Asia Pac J Clin Oncol, 2018, 14(5): e490-e497.
- 15. Castillo-Fortu?o à, Páez-Carpio A, Matute-González M, et al. Lung cryoablation: patient selection, techniques, and postablation imaging. Radiographics, 2025, 45(6): e240157.
- 16. Yang R, Gu C, Xie F, et al. Potential of thermal ablation combined with immunotherapy in peripheral lung tumors: a review and prospect. Respiration, 2024, 103(6): 295-316.
- 17. Alexander E, Petre E, Offin M, et al. Safety and efficacy of percutaneous cryoablation for primary and metastatic pleural based tumors. Eur J Radiol, 2024, 175: 111465.
- 18. Callstrom M, Woodrum D, Nichols F, et al. Multicenter study of metastatic lung tumors targeted by interventional cryoablation evaluation (SOLSTICE). J Thorac Oncol, 2020, 15(7): 1200-1209.
- 19. Kammoun T, Prévot E, Serrand C, et al. Feasibility and safety of single-probe cryoablation with liquid nitrogen: an initial experience in 24 various tumor lesions. Cancers, 2022, 14(21): 5432.
- 20. Lyons G, Winokur R, Pua B. Pulmonary cryoablation zones: more aggressive ablation is warranted in vivo. AJR Am J Roentgenol, 2018, 212(1): 195-200.
- 21. Moore W, Talati R, Bhattacharji P, et al. Five-year survival after cryoablation of stage Ⅰ non-small cell lung cancer in medically inoperable patients. J Vasc Interv Radiol, 2015, 26(3): 312-319.
- 22. Yamauchi Y, Izumi Y, Hashimoto K, et al. Percutaneous cryoablation for the treatment of medically inoperable stage Ⅰnon-small cell lung cancer. PLoS One, 2012, 7(3): e33223.
- 23. Shi F, Li G, Zhou Z, et al. Microwave ablation versus radiofrequency ablation for the treatment of pulmonary tumors. Oncotarget, 2017, 8(65): 109791-109798.
- 24. Hasegawa T, Sato Y, Kuroda H, et al. Clinical outcomes and techniques for radiofrequency ablation of lung tumors smaller than 1 cm. Interv Radiol, 2020, 5(2): 94-102.
- 25. Yang X, Jin Y, Lin Z, et al. Microwave ablation for the treatment of peripheral ground-glass nodule-like lung cancer: long-term results from a multi-center study. J Cancer Res Ther, 2023, 19(4): 1001-1010.
- 26. Ye X, Fan W, Wang Z, et al. Expert consensus on thermal ablation therapy of pulmonary subsolid nodules (2021 edition). J Cancer Res Ther, 2021, 17(5): 1141-1156.
- 27. Alzubaidi S, Liou H, Saini G, et al. Percutaneous image-guided ablation of lung tumors. J Clin Med, 2021, 10(24): 5783.
- 28. Geevarghese R, Alexander E, Elsakka A, et al. Outcomes following microwave ablation of 669 primary and metastatic lung malignancies. Eur Radiol, 2025, 36(3): 2295-2304.
- 29. Yamauchi Y, Izumi Y, Kawamura M, et al. Percutaneous cryoablation of pulmonary metastases from colorectal cancer. PLoS One, 2011, 6(11): e27086.
- 30. Meng M, Han X, Li W, et al. CT-guided microwave ablation in patients with lung metastases from breast cancer. Thorac Cancer, 2021, 12(24): 3380-3386.
- 31. Liu BD, Ye X, Fan WJ, et al. Expert consensus on image-guided radiofrequency ablation of pulmonary tumors: 2018 edition. Thorac Cancer, 2018, 9(9): 1194-1208.
- 32. Hung WT, Tsai S, Wu TC, et al. Enhancing precision in lung tumor ablation through innovations in CT-guided technique and angle control. Thorac Cancer, 2024, 15(11): 867-877.
- 33. Wang Z, Wu W, Wu S, et al. An automatic needle puncture path-planning method for thermal ablation of lung tumors. Diagnostics, 2024, 14(2).
- 34. Ye X, Fan W, Wang Z, et al. Clinical practice guidelines on image-guided thermal ablation of primary and metastatic lung tumors (2022 edition). J Cancer Res Ther, 2022, 18(5): 1213-1230.
- 35. Yao P, Ye X, Wang M, et al. Safety and efficacy of microwave ablation versus argon-helium cryoablation for the treatment of primary high-risk pulmonary nodules: a propensity score-matched study. Quant Imaging Med Surg, 2025, 15(12): 12765-12776.
- 36. Bourgouin P, Wrobel M, Mercaldo N, et al. Comparison of percutaneous image-guided microwave ablation and cryoablation for sarcoma lung metastases: a 10-year experience. AJR Am J Roentgenol, 2021, 218(3): 494-504.
- 37. Jiang B, Mcclure M, Chen T, et al. Efficacy and safety of thermal ablation of lung malignancies: a network meta-analysis. Ann Thorac Med, 2018, 13(4): 243-250.
- 38. Zhang W, Liu W, Wu ZL, et al. Percutaneous ablation for adrenal metastasis from non-small-cell lung cancer: comparison between cryoablation and microwave ablation. Videosurgery Miniinv, 2024, 19(1): 52-59.
- 39. Li HW, Long YJ, Yan GW, et al. Microwave ablation vs. cryoablation for treatment of primary and metastatic pulmonary malignant tumors. Mol Clin Oncol, 2022, 16(3): 62.
- 40. Macchi M, Belfiore M, Floridi C, et al. Radiofrequency versus microwave ablation for treatment of the lung tumours: LUMIRA (lung microwave radiofrequency) randomized trial. Med Oncol, 2017, 34(5): 96.
- 41. Nan FY, Liu XF, An P, et al. Comparison of the efficacy and adverse events between argon-helium cryoablation and microwave ablation for non-small cell lung cancer: a propensity score matching study. J Thorac Dis, 2025, 17(7): 4587-4599.
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